Clinical Audit of Low Dose Prophylaxis Programme for Nigerian Children with Haemophilia

• Published in: West African journal of medicine Vol. 39; no. 1; p. 11
• Main Authors: Nwagha, T U, Okoye, H C, Udo, C E, Yuguda, S, Korubo, K I, Adeyemo, T A
• Format: Journal Article
• Language: English
• Published: Nigeria 31.01.2022
• Subjects: Child; Clinical Audit; Female; Hemarthrosis - etiology; Hemarthrosis - prevention & control; Hemophilia A - drug therapy; Humans; Nigeria; Quality of Life; Nigeria; Low dose prophylaxis; Quality of Life; Haemophilia; Nigeria; Factor VIIII concentrate
• ISSN: 0189-160X

The evidence of benefits for prophylaxis especially low dose prophylaxis is incontestable yet most children in developing countries as Nigeria do not have access to this treatment protocol. The aim was to audit the low dose prophylaxis treatment in Nigerian children with haemophilia. A multicentre clinical audit of five haemophilia treatment centres; University of Nigeria Teaching Hospital Enugu, Lagos University Teaching Hospital, National Hospital Abuja, University of Port Harcourt Teaching Hospital Port Harcourt, and Federal Teaching Hospital Gombe. Eighteen children with mild-severe haemophilia were enrolled into low-dose prophylaxis treatment programme. The reduction of joint bleeding, improvement of joint function and Quality of Life (QoL) during prophylaxis were analysed. In total 18 children - 17males and 1 female (median age 8 years) were enrolled. The median duration of observation was 7 months (range 3-15months). Seven of the children were on primary prophylaxis (41%) while 10 of the children (59%) were on secondary prophylaxis. The number of joint bleeds decreased from a total of 162 (individual range 5-20, mean 10.3) to 42 (range 0-7, mean 3.0) during the observation period with an overall reduction of 74%. Joint function improved in 94.1% of disease joints, while only 5.6% reported no improvement (due to poor compliance). School attendance improved in all subjects, sports participation and daily activity improved moderately. Low dose prophylaxis was beneficial in reduction of joint bleeds, improvement of joint function and improvement of QoL of Children with haemophilia in Nigeria.